Reopening States Must Choose: More Financial Doom or COVID-19 Death Spikes?

By Adam Townsend

In a bleak experiment never tried in human history, US states are bringing their citizens and businesses out of COVID-19-induced social distancing measures – some more quickly than others.

Despite enormous economic pressures to reopen, experts predict reopening too soon could result in tens of thousands more deaths.

Critics of continued isolation policies point to the increase in suicide, addiction, mental health problems and other increases in mortality that always result from job loss and poverty, illustrating there is no good option, now, in response to the deadly coronavirus infecting the planet.

“I think the secondary phase openings, if it’s done too fast, will end up with a lot more deaths than we want to see -- that means men, women, children and the elderly,” said Charles Patrick Davis, MD, PhD, an emergency medicine doctor and microbiologist who sits on MedicineNet’s editorial board. “That’s everybody. I think it’s important for us to walk that line to save as many as we can, but it’s also important to get back to work, within reason.”

Davis acknowledged that it’s difficult to get people to stay at home and watch their finances fall into ruin when there is no end date.

“Even if we flatten out the curve, we’re only delaying the numbers of sick people in the hope we can get a vaccine or a drug and also save capacity in the hospital system for other emergencies,” Davis said. “It’s a race against time. If you had a vaccine available in a couple weeks, that would be wonderful, but that’s not in our future.”

Does Any State Meet Reopening Criteria?

COVID-19 continues to ravage the U.S., infecting tens of thousands daily. It has killed nearly 70,000 as of May 4, according to provisional statistics from the CDC and other sources.

(Death and infection rates are assumed to be higher than the numbers reflect because not all cases and deaths are tested for presence of the SARS-CoV-2 virus that causes COVID-19).

Dr. Davis doesn’t think any state in the country meets the White House/CDC guidelines for reopening. These include a 14-day downward trend in new tested COVID-19 cases, new cases of pneumonia/flu hospital admissions and a robust mass testing policy in place locally, among other measures.

“If you’re looking at the country as a whole or any state as a whole, there are very few meeting any of these requirements for sure,” Davis said. “The virus doesn’t respect the state borders, and people who go state-to-state for employment will start doing so. This really needs to be more of a universal setup than a state-by-state situation.”

Though some towns and counties may meet the criteria, there is no way to isolate those places from the country at large.

“Having said that, there are probably some areas in the US that will meet the requirements -- different counties or rural towns -- but they also have the same problem of people coming through to do business,” Davis said.

How Are States Reopening?

Politicians and pundits on both sides of the political aisle are staking their reputations on a COVID-19 response. Republican governors generally favor faster reopening while Democrats are more likely to favor more extensive lockdowns.

But despite the best efforts of the political class to turn COVID-19 into a partisan issue, many states are divergent in their responses independent of the party in power. Some 24 states are reopening aggressively early this month, or even started in April (as opposed to the mid- to late-May reopening planned in stricter states), NBC News states.

Most of these states –17 – are led by Republican administrations, but seven are run by Democrats, according to NBC.

Colorado’s Democratic Gov. Jared Polis, for instance, was letting Colorado residents get haircuts late last month. People seem to like him for it: his approval rating is at 75% according to a May 3 NBC news report.

Conversely, Gov. Mike Dewine, R-Ohio is popular with both the public in his state and public health experts for his strict imposition of the state’s lockdown, following advice of medical professionals to help halt the spread. People in Ohio seem to like him for it, too: A poll by a Harvard-led university group showed April 30 that 84 percent of Ohioans are happy with Dewine’s handling of the pandemic.

Ohio’s statewide stay-at-home order is in effect until May 29, and phased reopening of non-emergency medical visits, manufacturing and distribution are all set to resume in a limited way the week of May 4, with retail shops and other businesses opening in a limited way the week of May 12, according to the governor’s plan reported by CNN.

But Dewine’s fellow Republican governor in Alabama, Kay Ivey, issued a much less stringent set of guidelines for businesses and social gatherings, and it only went into effect a few days ago. The statewide order came after county and state officials implemented stricter local measures throughout March and April to stave off clusters in different cities, according to the text of Ivey’s “Safer at Home” order. Businesses like retailers are required to have extra sanitation procedures in place, limit the number of customers, and require face masks, for example.

But in Alabama, the order expires May 15.

Gov. Gavin Newsom, D-California, has been one of the most aggressive in implementing COVID-19 countermeasures. Even as the phased reopening started to commence this month, Newsom slapped a new closure order on Orange County after news photos showed huge crowds on local beaches. Still, on Monday Newsom rescinded the order for other OC beaches and allowed clothing stores, florists and book shops to open with curbside pickup statewide, according to CNN.

There is no official end date for lifting the California orders, but Newsom said on May 1 he is “days, not weeks” from beginning to lift more restrictions, according to CNN.

Will Warm Weather Make a Difference in COVID-19 Transmission?

Some experts have hypothesized that summer temperatures and extra sunlight will significantly reduce how contagious the coronavirus is. That would certainly be a handy fact if it is true, given reopening plans coincide with late spring, but there isn’t any evidence for it now.

Dr. Davis is skeptical of people who stake their hopes on warm weather reducing the transmission of COVID-19.

“It’s a possibility that warm weather may slow the transmission of COVID-19, but it’s not proven,” Davis said. “We’re not sure that’s going to happen. What is certain is if you don’t protect against the virus, it’s going to reemerge. The evidence is strong for that. The second-largest Japanese island of Hokkaido had a pretty good downward trend in cases. They opened back up, and three weeks later they had to close it back down again.

“Hong Kong and Singapore also had a drop in cases and opened up, and had to shut down again,” Davis continued. “There are three different examples that all point to the same fact: If you’re not careful about opening up, the virus will resurge.”

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